Pelvic Floor Disorders

Pelvic floor is the group of muscles lining the pelvis. The pelvic floor organs include bladder, urethra, vagina, anus, and rectum. Any diseases or disorders that affect these pelvis floor muscles can lead to pelvic floor deformities.

Some of the pelvic floor disorders are explained below

Urinary incontinence: Refers to loss of bladder control resulting in involuntary leakage of urine. It commonly occurs in women due to pregnancy and childbirth, menopause and the structure of the female urinary tract. There are two types of urinary incontinence; stress incontinence and urge incontinence.

Stress incontinence – Refers to leakage of small amounts of urine during physical activities such as coughing, laughing, sneezing, or exercising that suddenly increases the pressure within the abdomen.

Urge incontinence – This condition refers to urine leakage with the sudden urge to urinate or unable to hold the urine.

Pelvic organ prolapse: This condition most commonly occurs in women when the pelvic floor organ shifts from the normal position bulges out against the walls of vagina. When this condition occurs you may feel a bulge coming out of the vaginal opening. The condition occurs due to weak or stretched pelvic muscles resulting from childbirth or surgery. There are different types of pelvis organ prolapse, such as rectocele, cystocele, enterocele, and uterine prolapse.

Your doctor will diagnose the condition by performing physical examination, including pelvic exam, medical and family history and may perform other tests such as cystoscopy, ultrasound scan, and magnetic resonance imaging (MRI).

Treatment options include physical therapy, biofeedback, and medicines which will weaken the vaginal muscles and ease the pelvic muscles. Pessary, a removable device fitted in vagina to reduce pain and pressure of pelvic organ prolapse. If the non surgical treatment does not reduce the symptoms of pelvic organ prolapse, then surgery treatment is considered.. There are several types of surgeries to correct different types of pelvic floor prolapse and may include:

Repair of the vaginal wall

Repair of prolapsed pelvic organ

Closure of the vaginal opening

Removal of uterus

Fecal incontinence: It is the inability to control bowel movements which leads to passing of stool accidentally. It occurs when pelvic muscles are damaged during child birth, constipation, anal or nerve injury, and rectal prolapse.

Your physician will perform physical examination and may order other tests such as anal manometry, Magnetic resonance imaging (MRI), Anorectal ultrasonography, Proctography, Proctosigmoidoscopy and Anal electromyography to diagnose fecal incontinence.

To restore the bowel control, diet and lifestyle changes, medicines and physical exercises are suggested as a part of treatment. If the non surgical techniques do not work then surgery would be considered as a last treatment option. Sphincteroplasty, the most common fecal incontinence surgery indicated, and the surgery involve reconnecting the separated ends of a sphincter muscle injured by childbirth or other injuries.

Defecatory dysfunction: Refers to difficulty in emptying the bowels. Symptoms may include frequent and uncomfortable sensation to have bowel movements, constipation and leakage of gas, diarrhea, or solid stool.

Voiding dysfunction: This condition refers to inability to completely empty the bladder. It most commonly affects children. In normal case, when an individual wants to have a bowel movement, the pelvic muscles relaxes and the abdominal muscles contract allowing to empty the bowel. But in the voiding dysfunction, the pelvic muscles contract instead of relaxing resulting in incomplete emptying of urine.

Treatment options for voiding dysfunction include managing constipation, treating urinary tract infections, physical exercises, and medicines to decrease the bladder hyperactivity, diet changes are suggested. Surgery is rarely considered and involves correction of anatomical abnormality that is causing the voiding dysfunction.